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The Callers Longer Care Program The Callers Longer Care Program Assignment of Benefits Date: Claimant Name: Coverage ID Number: 41I, the Claimant or the guardian of the Claimant (legal documentation

How to fill out form calpers long-term care

How to fill out form CalPERS long-term care:

1. Start by gathering all necessary information and documents such as personal details, contact information, and relevant financial information.
2. Carefully read through the instructions provided with the form to understand the requirements and properly fill out the sections.
3. Begin by entering your personal information in the appropriate fields, including your full name, address, Social Security number, and date of birth.
4. Provide details about your current health condition and any pre-existing medical conditions you may have.
5. Indicate your desired coverage options and any specific requirements you have regarding long-term care.
6. Next, enter details about your financial situation, including your income, assets, and any existing insurance policies.
7. If applicable, provide information about your spouse or partner who will also be covered under the long-term care plan.
8. Make sure to review and double-check all the information you entered for accuracy and completeness.
9. Sign and date the form where indicated, and consider making a copy of the completed form for your records.
10. Finally, submit the form as directed, either by mailing it to the appropriate address or submitting it online through the CalPERS website.

Who needs form CalPERS long-term care?

1. Individuals who are currently employed by a participating CalPERS employer and are eligible for long-term care benefits through CalPERS.
2. Retired CalPERS members who have chosen to continue long-term care coverage through the program.
3. Family members or loved ones who are assisting eligible individuals in applying for and managing their long-term care coverage through CalPERS.

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